Superbug infections must be listed on death certificate under proposed bill

Carbapenem-resistant Enterobacteriaceae (CRE) bacteria is believed to have caused outbreaks at several Southern California hospitals, including at Ronald Regan UCLA Medical Center. Three patients died in that outbreak that began in late 2014. (Getty Images)

State Sen. Jerry Hill introduced a bill Monday that would require doctors to record antibiotic-resistant infections on death certificates if they played a role in the death.

Currently many deaths from infections acquired in hospitals and nursing homes are not publicly recorded, leaving health officials to guess at their toll.

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"Today we have to estimate the number of deaths from infections and we have no idea if that is accurate," said Hill (D-San Mateo). "We're shooting in the dark."

The Centers for Disease Control and Prevention projects that 75,000 Americans die of hospital-acquired infections each year. Because California provides between 10% and 12% of the nation's hospital care, state officials estimate that 7,500 to 9,000 Californians die each year from the infections.

A 2014 study by University of Michigan researchers concluded that infections – both those acquired inside and outside hospitals – would replace heart disease and cancer as the leading causes of death in hospitals if the count was performed by looking at patients' medical billing records, rather than death certificates. The billing records show what patients were being treated for.

The Times reported in October about the death of Sharley McMullen at Torrance Memorial Medical Center. In McMullen's medical records, doctors detailed how the Manhattan Beach resident died of a superbug that sickened her after a surgery and other procedures at the hospital. McMullen's doctor did not list the bacteria on her death certificate.

The bill, SB 43, would also require labs that conduct testing for hospitals and other medical facilities to annually give state officials a summary of how many patients tested positive for each type of antibiotic-resistant bacteria.

Hill said state officials could use the information on infections and deaths to look for dangerous trends and create prevention strategies. The information would be reported to the public, he said, but hospitals would not be named.

Hospitals are already required to report some types of hospital-acquired infections to health officials. That data does not include whether the patient died.

McMullen was infected with carbapenem-resistant Enterobacteriaceae or CRE, a lethal superbug that is not among those that hospitals now must report. The CDC has classified the bacteria, which kills as many as half its victims, as one of the nation's most urgent health threats.

The superbug caused outbreaks at several Southern California hospitals beginning in late 2014 that were traced to a type of medical scope that was especially hard to clean.

Torrance Memorial officials have not said how McMullen became sickened in the middle of 2014. But they said they had ruled out the two scope procedures that she had just before her surgery for a stomach ulcer.

Her doctor wrote on the death certificate that McMullen died from respiratory failure and septic shock caused by her ulcer.

A Torrance Memorial spokeswoman said Monday that the hospital could not release information from a completed investigation into the case "due to patient privacy laws."